Dental Sedation for Children in Hampton Roads - Virginia Beach | Norfolk | Chesapeake
Unlike most other dental practices, Coastal Pediatric Dental & Anesthesia was built with anesthesia at its core. From the beginning, Coastal Pediatric Dental & Anesthesia planned for anesthesia, building an outpatient dental surgical facility adhering to the standards of care for outpatient surgery and the Life Safety Code. At Coastal Pediatric Dental & Anesthesia, We Make Dentistry a Dream.
Anesthesia for Dentistry
Simply put, anesthesia is the use of medications to create a temporary loss of feeling or consciousness. Every day, dentists use local anesthesia to “numb” their patients for dental procedures. Although this is adequate for most patients, some patients simply cannot tolerate dental work in this fashion. This may be due to factors such as age or maturity, medical issues, anxiety or fear, extensive dental treatment needs, or an inability to cooperate.
Coastal Pediatric Dental & Anesthesia offers the full spectrum of anesthesia options for our patients with a focus on your safety. This is what sets us apart from other so called “sleep dentists.” Our Dentist Anesthesiologists deliver a full spectrum of anesthesia options, including general anesthesia. They create a tailored anesthesia plan for you with full understanding of your health and the procedures you need.
Dental Anesthesiology / Dentist Anesthesiologist
Dental anesthesiology (or dental anaesthesiology also commonly known as “dental sedation”) is a dentistry specialty that deals with the management of pain through the use of advanced local and general anesthesia techniques. A dentist anesthesiologist is a dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists, currently lasting three or more years, in accord with Commission on Dental Accreditation’s Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.
Such programs have extensive in-hospital and outpatient training, with dentist anesthesiologists training alongside their physician anesthesiologist colleagues. Dentist anesthesiologists use their advanced training to provide full-scope anesthesia for dentistry in an outpatient setting.
Spectrum of Anesthesia
Local anesthesia is the most basic form of anesthesia. The patient is awake during local anesthesia, but an injection blocks their feeling or sensation. This injection is often lidocaine, articaine, or marcaine. These medications prevent the full sensation of the procedure by blocking the nerve signals to the brain so the patient does not feel the pain of the procedure. However, patients can also feel a deep pressure sensation. This is what is typically experienced when you visit your usual dentist or a pregnant woman is given an epidural before childbirth.
Doctors can use local anesthesia to accomplish many surgical procedures in medicine, but the standard of care is to provide deeper levels of anesthesia for many of these medical procedures. Nevertheless, patients can choose to be awake, as noted in this article from the NY Times. Local anesthesia is the norm for dental procedures. Coastal Pediatric Dental & Anesthesia can give you other options if you need more than just local anesthesia.
Sedation is a medically induced altered state of consciousness. In anesthesia, there’s a continuum ranging from minimal sedation to deep sedation and then general anesthesia. There is often significant confusion in dentistry regarding the levels of sedation and anesthesia. You may read the updated guidelines here: American Dental Association: 2016 Sedation Guidelines. It is important to note that these now coincide with the American Society of Anesthesiologists’ Continuum of Anesthesia.
Minimal sedation, previously called anxiolysis, includes nitrous oxide (laughing gas) and hypnosis techniques. The patient is still awake and needs minimal, if any, monitoring.
The doctor/dentist may give oral (enteral) or IV (parenteral) medications to achieve moderate sedation. They may also give nitrous oxide in conjunction with them. The patient should be purposefully responsive to verbal or light stimulation. Many “sleep dentists” offer “Oral Conscious Sedation” or “IV Sedation”; however, patients under this type of anesthesia are supposed to be awake.
The doctor will give IV medications to achieve deep sedation. The patient needs careful monitoring, as supporting their breathing may be necessary. The patient should respond purposefully to repeated or painful stimulation. Deep sedation can be very effective when used in conjunction with local anesthesia.
General Anesthesia is what we think of when we think of having surgery at the hospital. Although it is often called “going to sleep,” it is actually much different.
General anesthesia is a medically induced unconscious state that is reversed when the surgical or dental procedure is completed. The patient has no awareness or memory of the procedure and is pain-free during its course. The anesthesiologist will continuously monitor the patient and may have to support the patient’s airway and cardiovascular functions.
Anesthesiologists often mix a combination of local (or regional) anesthesia with inhalational and intravenous (IV) agents to produce general anesthesia. This is called a balanced technique, which helps reduce the side effects of each of the drugs used. Coastal Pediatric Dental & Anesthesia uses short-acting, fast-emergence (SAFE) drugs so you can recover and go home quickly.
Check out Dr. Wong’s TED-Ed Lesson on Anesthesia, or watch Stephen Zeng’s Ted-Ed lesson below.